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Palliative Care in Hematopoietic Stem Cell Transplantation

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Palliative Care in Pediatric Oncology

Part of the book series: Pediatric Oncology ((PEDIATRICO))

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Abstract

Hematopoietic stem cell transplantation (HSCT) offers a potentially curative treatment for children with advanced hematologic and some non-hematologic malignancies. Since the risk for severe toxicity, treatment-related death, or significant long-term sequelae still substantially exceeds the risks of conventional cancer therapy, HSCT is only considered after relapse or in high-risk cases. Pediatric HSCT patients and their families often face a high burden of symptoms and suffering throughout the immediate course of the transplant and sometimes for years thereafter. Palliative care can introduce aspects of quality of life into the transplant procedure to reduce suffering and support families to cope with long-term sequelae and therapy failure. Specialized pediatric palliative care services could provide much needed additional support during the inpatient phase of the transplant, bridge the gap to the home care setting, assist in care coordination, and take care of the physical, emotional, and spiritual suffering of the patient and the family. Furthermore, palliative care counseling may be helpful in facilitating goals-of-care discussions and advance care planning before HSCT and during the posttransplant phase. Although therapy-related mortality has considerably decreased in the last two decades, a significant number of pediatric HSCT recipients still die due to relapse, acute treatment-related complications, or progressing chronic conditions. In these children, integration of pediatric palliative care can facilitate end-of-life communication and reduce unwarranted interventions such as intubation or cardiopulmonary resuscitation close to the end of life.

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Authors and Affiliations

  1. Dr. von Hauner Children’s Hospital, University Clinics Munich, Munich, Germany

    Monika Führer

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  1. Monika Führer
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Correspondence to Monika Führer .

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Editors and Affiliations

  1. Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

    Joanne Wolfe

  2. School of Social Work, The University of Texas, Austin, Texas, USA

    Barbara L. Jones

  3. Department of Caring Sciences, Palliative Research Centre, Stockholm, Sweden

    Ulrika Kreicbergs

  4. Hospital san Gerardo, University of Milano, Monza, Italy

    Momcilo Jankovic

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Führer, M. (2018). Palliative Care in Hematopoietic Stem Cell Transplantation. In: Wolfe, J., Jones, B., Kreicbergs, U., Jankovic, M. (eds) Palliative Care in Pediatric Oncology. Pediatric Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-61391-8_6

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